CPT 44403 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • PT - Colorectal cancer screening test; converted to diagnostic test or other procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 44403 |
National average reimbursement for CPT 44403 by major payers:
$421.33
$426.03
$422.35
$539.49
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 44403 | ||||||
United | 44403 | $461.00 | 1669954707 - CARDIOVASCULAR SURGICAL SUITES LLC | 831614285 - (FL) CARDIOVASCULAR SURGICAL SUITES L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $1276.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $365.00 | 1669668943 - POOLE ENDOSCOPY CENTER, NEEL KAMAL MD | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $780.00 | 1366799033 - UPSTATE GASTROENTEROLOGY, LLC | 270998899 - (NY) UPSTATE GASTROENTEROLOGY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $487.00 | 1528099207 - DEER CREEK SURGERY CENTER, LLC | 202255269 - (KS) DEER CREEK SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $1814.00 | 1730277575 - BEDFORD AMBULATORY SURGICAL CENTER, LLC | 20519727 - (NH) BEDFORD AMBULATORY SURGICAL CENTER LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $1100.00 | 1407812498 - LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP | 364119522 - (IL) LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $3022.00 | 1508974353 - SOUTHLAKE AMBULATORY SURGERY CENTER, LLLP, SPIVEY STATION SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $1367.00 | 1790724862 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE EASTSIDE SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $1050.00 | 1871550392 - CONNECTICUT SURGERY CENTER LIMITED PARTNERSHIP | 61592173 - (CT) CONNECTICUT SURGERY CENTER LIMITED PARTNERSHIP | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $1955.00 | 1992721591 - DAY SURGERY CENTER OF NORTH TEXAS LTD | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $690.00 | 1073663480 - DOCTORS CLINIC A PROFESSIONAL CORPORATION, THE DOCTORS CLINIC AMBULATORY SURGERY CENTER | 911939739 - FRANCISCAN MEDICAL GROUP | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $319.00 | 1992845283 - CHESAPEAKE AMBULATORY SURGERY CENTER | 522240631 - (MD) CHESAPEAKE AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $553.00 | 1881002343 - INNOVATIVE SURGERY CENTER, LLC | 471395981 - (MD) INNOVATIVE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44403 | $580.00 | 1184697930 - THE ALEXANDRIA OPHTHALMOLOGY ASC LLC, WALLACE LASER AND SURGERY CENTER | 752830937 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 44403 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44403 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 44403 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 44401-CPT | High | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimenss By Brushing Or Washing When Performed With Ablation Of Tumors, Polyps, Or Other Lesionss Inc |
| 44402-CPT | Moderate | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimenss By Brushing Or Washing When Performed, With Endoscopic Stent Placement Including Pre And Post-Dil |
| 44403-CPT | Moderate | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimens(S) By Brushing Or Washing When Performed; With Endoscopic Mucosal Resection |
| 44404-CPT | Moderate | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimens(S) By Brushing Or Washing When Performed; With Directed Submucosal Injections(S), Any Substance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44403. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44403 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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